Organization
BENEDETTA S HAIR SALON & SPA CO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH SANDRA GAGNON COMETOLOGIST (MEDICAL HAIR LOSS)
(586) 263-9968
Entity
Organization
Contact information
Practice address
42302 HAYES RD, CLINTON TOWNSHIP, MI 48038-3620
(586) 263-9968
(586) 263-3947
Mailing address
42302 HAYES RD, CLINTON TOWNSHIP, MI 48038-3620
(586) 263-9968
(586) 263-3947
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
2701290519
MI
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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